Puzzle on the fluctuation of vitals

[Hurling24]

Hi

looking for help, My husband has stage 4 PC Mets to bone and lymph nodes. He has had many trials and treatment all failed after a short period of time. He was due to start Cabazitaxel three months ago but ran into trouble with his bowel and has since been diagnosed with Crohn's and has had infusions to settle this. Was due to start chemo last Tuesday his Temp was up, his bp low, and his heart rate increased so chemo canceled at admitted to hospital. There they have run many tests, ct scans, bone scans, chest X-rays and still no answer. This morning his oxygen levels had dropped has had a respiratory consult and he failed to find anything. Any ideas!! Thanks

[Tall_Allen]

Sepsis? What is his WBC count doing?

[Hurling24 in reply to Tall_Allen]

That’s what I thought but the WRC doesn’t reflect that

[Tall_Allen in reply to Hurling24]

How is his kidney function? Is he taking a corticosteroid?

[Hurling24 in reply to Tall_Allen]

He has been on Prednisone by the bucket load while getting Crohn's undercontrol was on 60 and is working his way down to 15 , and has been on 15 on and off over the past 2 years

[Tall_Allen in reply to Hurling24]

Maybe it has something to do with his prednisone history? How is his sodium, potassium and aldosterone?

Also, the prednisone may be suppressing his WBC reaction to an underlying infection.

[Hurling24 in reply to Tall_Allen]

Thank you I will ask tomorrow.

[Hurling24 in reply to Tall_Allen]

The latest is the Doctors believe it was a reaction to ENTYVIO this is the infusion he had for Crohn's. He has since had cabazitaxel and another infusion shot with no recurrance of the problem. He is due to have his next chemo on the 19th it is every three months. Today he has had a problem with tingling around his mouth and a feeling of full lips anyone shed some light?. still laughing . He says if he were a horse he would be put down as the vet bills would be enormous.

[NPfisherman]

Several thoughts come to mind--Is it cancer related?? See below:

antimicrobe.org/e13.asp

The fact that he had Crohn's, is he still having some loose stools?? If so, a stool for WBC's and C. difficile toxin A and B may be in order to rule out an infectious process in his bowel.

I take it there are no new meds involved. I am sure a urinalysis has been done to evaluate for infections, but if not, that is in order.

He has had multiple scans--CT, CXR, etc... I believe an ID MD and your MO should be putting their heads together...

Best of luck...

Don Pescado

[Hurling24 in reply to NPfisherman]

Thanks I will check all but I believe bloods swaps taking again today in case there is a change from Tuesday. The ct scan shows an improvement in the bowel from two weeks ago so they are saying it’s not the crohrn’s. Thank you I will update tomorrow when I speak to the Doctors again.

[NPfisherman in reply to Hurling24]

Clostridium difficile or other types of bowel infections can still be going on regardless of Crohn's if he has loose stools...the WBC may be WNL because he is immunocompromised and some of the cancer meds cause decreased WBC's... I would look at stool specimens and urine....

Also, the fact that he has a normal chest Xray does not rule out Pneumonia--especially viral--see below:

ebmedicine.net/content.php?...

Some things to take to your docs...

Best of luck...

Don Pescado

[Hurling24 in reply to NPfisherman]

Thank you

[j-o-h-n in reply to Hurling24]

You've been a member for awhile.... please fill us in on HIS VITALS as related to his Pca. Age? Location? Treatments? Treatment center(s)? Doctor's name(s)? All info is voluntary. Thank you...

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 08/28/2019 11:41 AM DST - Pinnes.

[Hurling24 in reply to j-o-h-n]

location Ireland . age 55 when diagnosed in 2016 stage 4 Mets to bones and lymph node involvement. Began hormone injections and continues on same every three months. Went on Zytiga PSa dropped from 900s to 39 but after 9mths with rise in PSA progression on scans had docetaxel 6 sessions. Held steady for a few months and PSA rose again started on trial for Rucaparib had gene testing nothing other than ATM mutation stopped on trial as it was shown no benefits to ATM. Up until this time has been extremely active and working more or less as normal. Since January has had problems with bowel and was diagnosed as Crohn's last april. Had one doze of cabazitaxel but had to stop as he was unwell due to Crohn's ( has lost a significant amount of weight) Had 2nd dose last Thursday. He has had radiotherapy for pain mainly hip area over the past 3 years. He is active but not great. Hope this helps others.

[j-o-h-n in reply to Hurling24]

Thank you.... The ole sod, sorry I should have guessed based on your user ID. Please keep on posting here... lots of information and camaraderie. Remember God is on your side.

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 09/11/2019 11:05 AM DST - Another day to remember.

[Hurling24 in reply to j-o-h-n]

Thank you

[Hurling24]

The latest is the Doctors believe it was a reaction to ENTYVIO this is the infusion he had for Crohn's. He has since had cabazitaxel and another infusion shot with no recurrance of the problem. He is due to have his next chemo on the 19th it is every three months. Today he has had a problem with tingling around his mouth and a feeling of full lips anyone shed some light?. still laughing . He says if he were a horse he would be put down as the vet bills would be enormous.